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Intake of multivitamin supplements and incident asthma in Norwegian adults: the HUNT study

Lin Jiang, Ben Brumpton, Arnulf Langhammer, Yue Chen, Xiao-Mei Mai
ERJ Open Research 2015 1: 00036-2015; DOI: 10.1183/23120541.00036-2015
Lin Jiang
1Dept of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Ben Brumpton
1Dept of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
2Liason Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology, Trondheim, Norway
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Arnulf Langhammer
1Dept of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Yue Chen
3School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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Xiao-Mei Mai
1Dept of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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  • For correspondence: xiao-mei.mai@ntnu.no
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    FIGURE 1

    A flow chart of study cohort. HUNT: Nord-Trøndelag Health Study; HUNT2: 1995–1997; HUNT3: 2006–2008.

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  • TABLE 1

    Use of cod liver oil and multivitamin supplements by baseline characteristics in the Nord-Trøndelag Health Study in 1995–1997 to 2006–2008 (N=16 952)

    Reference group#Cod liver oil onlyMultivitamin supplements onlyUse of both
    Subjects13 742 (81)1163 (7)997 (6)1050 (6)
    Age at baseline years38.8±8.841.6±8.140.4±8.941.9±8.6
    Body mass index kg·m−225.7±3.825.5±3.525.4±3.925.4±3.7
    HADS
     Anxiety4.0±3.14.2±3.24.7±3.54.7±3.5
     Depression2.9±2.72.9±2.73.3±2.83.1±2.9
    Female sex7229 (52.6)657 (56.5)794 (79.6)741 (70.6)
    Current smoking3827 (27.9)239 (20.6)310 (31.1)264 (25.1)
    Physical activity <1 h per week3140 (22.9)202 (17.4)181 (18.2)179 (17.1)
    Education <10 years2511 (18.3)218 (18.7)181 (18.2)172 (16.4)
    Social benefit recipient2371 (17.3)189 (16.3)241 (24.2)268 (25.5)
    Having economic difficulty4384 (31.9)274 (23.6)357 (35.8)295 (28.1)
    Family history of asthma2254 (16.4)192 (16.5)188 (18.9)190 (18.1)
    Alcohol consumption ≥5 times per month1865 (13.6)182 (15.7)126 (12.6)152 (14.5)
    Any chronic disease at baseline1590 (11.6)194 (16.7)202 (20.3)249 (23.7)
    • Data are presented as n (%) or mean±sd. HADS: Hospital Anxiety and Depression Scale. #: nonusers or those with a daily intake of cod liver oil or multivitamin supplements for <3 months.

  • TABLE 2

    Subjects missing information on the use of cod liver oil or multivitamin supplements in in the Nord-Trøndelag Health Study, in comparison with subjects with complete data who were included in the analysis

    Subjects with complete dataSubjects with missing data
    Subjects n16 9526614
    Age at baseline years39.4±8.840.9±8.8
    Body mass index kg·m−225.6±3.726.0±4.0
    Female sex9421 (55.6)3648 (55.2)
    Current smoking4640 (28.9)2124 (33.8)
    Physical activity <1 h per week3702 (24.2)1632 (27.8)
    Education <10 years3082 (18.3)1611 (24.7)
    Social benefit recipients3069 (19.3)1005 (32.0)
    Having economic difficulty5310 (31.7)1164 (34.8)
    Family history of asthma2824 (17.7)614 (11.5)
    • Data are presented as mean±sd or n (%), unless otherwise stated.

  • TABLE 3

    The association of use of cod liver oil and multivitamin supplements with cumulative incidence of asthma over the 11-year follow-up period of the Nord-Trøndelag Health Study from 1995–1997 to 2006–2008 (N=16 952)

    Regular use of cod liver oil and multivitamin supplements in the previous yearSubjects nCases n (%)Crude OR (95% CI)Adjusted OR (95% CI)
    Model I#Model II¶Model III+
    Reference group§13 742389 (2.8)1.001.001.001.00
    Cod liver oil only116346 (4.0)1.41 (1.04–1.93)1.59 (1.16–2.19)1.59 (1.16–2.18)1.53 (1.11–2.11)
    Multivitamin supplements only99746 (4.6)1.66 (1.21–2.27)1.55 (1.12–2.13)1.54 (1.12–2.13)1.48 (1.07–2.05)
    Use of both105048 (4.6)1.64 (1.21–2.23)1.73 (1.26–2.37)1.73 (1.26–2.36)1.65 (1.20–2.26)
    • #: adjusted for age, sex, smoking (current, former, never and unknown), light physical activity, education, social benefit, economic difficulties, family history of asthma and body mass index; ¶: adjusted for alcohol consumption in addition to the covariates in model I; +: adjusted for Hospital Anxiety and Depression Scale (HADS) scores for anxiety and depression, and chronic disease at baseline, in addition to the covariates in model I (n=16 819 due to missing HADS scores); §: nonusers or those with daily intake of cod liver oil or multivitamin supplements for <3 months.

  • TABLE 4

    Sensitivity analysis using a stricter definition for asthma# (N=14 939)

    Regular use of cod liver oil and multivitamin supplements in the previous yearSubjects nCases n (%)Crude OR (95% CI)Adjusted OR (95% CI)
    Model I¶Model II+Model III§
    Reference groupƒ12 175238 (2.0)1.001.001.001.00
    Cod liver oil only100829 (2.9)1.49 (1.00–2.20)1.72 (1.16–2.56)1.71 (1.15–2.54)1.63 (1.09–2.44)
    Multivitamin supplements only86126 (3.0)1.56 (1.04–2.36)1.50 (0.99–2.28)1.49 (0.98–2.27)1.43 (0.94–2.18)
    Use of both89530 (3.4)1.74 (1.18–2.56)1.90 (1.28–2.83)1.90 (1.28–2.83)1.81 (1.21–2.70)
    • The association of the use of cod liver oil and multivitamin supplements with cumulative incidence of asthma over the 11-year follow-up period of the Nord-Trøndelag Health Study from 1995–1997 to 2006–2008. #: stricter definition for asthma was participants who were free from wheeze and asthma at baseline who reported asthma at follow-up in combination with use of asthma medication; participants who were free from wheeze and asthma both at baseline and at follow-up served as reference group. ¶: adjusted for age, sex, smoking (current, former, never and unknown), light physical activity, education, social benefit, economic difficulties, family history of asthma and body mass index. +: adjusted for alcohol consumption in addition to the covariates in model I. §: adjusted for Hospital Anxiety and Depression Scale (HADS) scores for anxiety and depression, and chronic disease at baseline, in addition to the covariates in model I (n=14 827 due to missing HADS scores). ƒ: nonusers or those with daily intake of cod liver oil or multivitamin supplements for <3 months.

Additional Files

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    Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.

    Files in this Data Supplement:

    • Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author. - The association of use of cod liver oil and multivitamin supplements with cumulative incidence of asthma over 11-year follow-up period, the HUNT Study, after excluding ever COPD, Chronic bronchitis or emphysema (n=16,711)
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    Files in this Data Supplement:

    • A. Langhammer
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Intake of multivitamin supplements and incident asthma in Norwegian adults: the HUNT study
Lin Jiang, Ben Brumpton, Arnulf Langhammer, Yue Chen, Xiao-Mei Mai
ERJ Open Research Oct 2015, 1 (2) 00036-2015; DOI: 10.1183/23120541.00036-2015

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Intake of multivitamin supplements and incident asthma in Norwegian adults: the HUNT study
Lin Jiang, Ben Brumpton, Arnulf Langhammer, Yue Chen, Xiao-Mei Mai
ERJ Open Research Oct 2015, 1 (2) 00036-2015; DOI: 10.1183/23120541.00036-2015
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